More than 20 million people had a substance use disorder in 2014, and only 2.5 million people received treatment. There are several barriers to treatment, including your own readiness to change, your responsibilities at home, and the fear that detox may be unpleasant or painful.
However, one of the most commonly cited barriers to treatment is the cost. An addiction treatment program is a health care intervention that’s designed to treat a chronic disease. Like other health care plans, procedures, and tests, addiction treatment can be costly.
However, at Family Recovery Specialists, we are committed to removing as many of these barriers to treatment as possible. That’s why we work with companies like Cigna to get as much coverage as possible for the treatments you need. Cigna is a long-standing insurance company with millions of insurance customers around the country. Learn more about how your Cigna insurance plan might cover you.
Health insurance companies are required to offer coverage for mental health services, including substance use disorders. That means things like detox and drug and alcohol rehab must receive some coverage.
The Affordable Care Act of 2008 requires health insurance companies to offer mental health coverage in addition to medical and surgical coverage. They are also required to follow mental health coverage parity regulations. That means insurance isn’t allowed to offer more or better coverage for medical or surgical coverage than they do for mental health.
In fact, they can’t even use more resources to provide coverage for service over the other. For instance, if there are fewer representatives who are ready to process claims for mental health and it slows down customer service, but they have more representatives for medical coverage, that would be out of compliance with the law.
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Yes. Cigna offers coverage for mental health and addiction treatment. Cigna offers coverage for both inpatient and outpatient treatment options.
However, they may require prior authorization for one or both of these services.
Prior authorization means that they will need to approve treatment and determine that it’s medically necessary before you can receive coverage.
This is as opposed to simply getting a referral from a doctor and going to get treatment without needing to get approved.
The company will evaluate your need for the services that your seeking.
For instance, if you are seeking medical detox, which is the highest level of care, the company will be looking for a medical need for treatment. Treatment options like outpatient may be approved with less scrutiny.
The amount of coverage you receive and coverage for specific treatment might depend on your plan with Cigna. You may need to speak to a Cigna representative to learn about the specifics of your plan and what kind of coverage you might receive. You can also speak to an addiction treatment specialist at Family Recovery Specialists.
We are dedicated to helping you deal with your insurance coverage as much as possible to help you focus on your recovery. We can help determine your eligibility and seek information about coverage.
SAMHSA. (2017, June 29). TRENDS IN SUBSTANCE USE DISORDERS AMONG ADULTS AGED 18 OR OLDER. Retrieved from https://www.samhsa.gov/data/sites/default/files/report_2790/ShortReport-2790.html
HealthCare.gov. (n.d.). Affordable Care Act (ACA) – HealthCare.gov Glossary. Retrieved from https://www.healthcare.gov/glossary/affordable-care-act/
MentalHealth.gov. (2019, March 22). Health Insurance and Mental Health Services. Retrieved from https://www.mentalhealth.gov/get-help/health-insurance
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
ASAM. (n.d.). What is the ASAM Criteria? Retrieved from https://www.asam.org/resources/the-asam-criteria/about